Health Services For Children With Special Needs Inc
Washington, DC, US
Base: $85,404.8 - $142,334.4; bonus/equity: not sp...
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Provider credentialing and recredentialing oversight
Ncqa cms doh accreditation standards knowledge
Process development for data quality
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The Credentialing and Provider Data Manager at Health Services for Children with Special Needs is responsible for overseeing provider credentialing processes, ensuring compliance with regulations, and managing provider data integrity. The ideal candidate should have extensive experience in credentialing and supervisory roles, with strong communication skills and familiarity with accreditation standards.
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Job Summary
The Credentialing and Provider Data Manager is responsible for overseeing all aspects of provider credentialing, recredentialing and the integrity of provider data within the health plan.
This role ensures compliance with federal and state regulations, accreditation standards such as NCQA, CMS, and DOH, and contractual obligations.
The Manager supervises the Provider Data Specialist and Credentialing Coordinators while serving as the primary point of contact for credentialing-related audits.
Matching Summary
Match Score: 75
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The Credentialing and Provider Data Manager at Health Services for Children with Special Needs is responsible for overseeing provider credentialing processes, ensuring compliance with regulations, and managing provider data integrity. The ideal candidate should have extensive experience in credentialing and supervisory roles, with strong communication skills and familiarity with accreditation standards.
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Salary
Base: $85,404.8 - $142,334.4; Bonus/Equity: Not specified; Benefits: Not specified
Skills & Requirements
Must-have
Provider credentialing and recredentialing oversight
NCQA CMS DOH accreditation standards knowledge
Process development for data quality
Supervising Provider Data Specialists and Coordinators
Managing provider directory updates
Nice-to-have
Experience with system automation implementation
Strong presentation and communication skills
Ability to manage multiple priorities in fast pace
Proven ability to improve process efficiency
Key Requirements
Bachelor's Degree (Preferred)
7 years Credentialing experience required
5 years Supervisory or management experience required